Bhutta Z A, Naqvi S H, Razzaq R A, Farooqui B J
Department of Pediatrics, Faculty of Health Sciences, Aga Khan University, Karachi, Pakistan.
Rev Infect Dis. 1991 Sep-Oct;13(5):832-6. doi: 10.1093/clinids/13.5.832.
Typhoid accounts for 8% of pediatric admissions to the Aga Khan University Hospital in Karachi, Pakistan. Over a 4-year period (1986-1989), 355 children had typhoid documented by culture of blood or bone marrow. Strains of Salmonella, resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole accounted for 20% of these cases. Compared with children infected by drug-susceptible strains of Salmonella, children with multiresistant infection were generally sicker at presentation and were more likely to be assessed as appearing "toxic" (P less than .001), as having disseminated intravascular coagulation (P less than .01), and as exhibiting hepatomegaly (P less than .01). The mortality was 4.2% among children with multiresistant infection and 1.4% among those infected with strains susceptible to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole; the higher mortality in the former group was probably due to a longer duration of illness (P less than .05) and to ineffectual oral antimicrobial therapy before hospitalization.
伤寒占巴基斯坦卡拉奇阿迦汗大学医院儿科住院病例的8%。在1986年至1989年的4年期间，355名儿童经血液或骨髓培养确诊为伤寒。对氨苄西林、氯霉素和甲氧苄啶-磺胺甲恶唑耐药的沙门氏菌菌株占这些病例的20%。与感染药敏性沙门氏菌菌株的儿童相比，多重耐药感染儿童在就诊时病情通常更严重，更有可能被评估为“中毒”（P<0.001）、患有弥散性血管内凝血（P<0.01）和肝肿大（P<0.01）。多重耐药感染儿童的死亡率为4.2%，而感染对氨苄西林、氯霉素和甲氧苄啶-磺胺甲恶唑敏感菌株的儿童死亡率为1.4%；前一组较高的死亡率可能是由于病程较长（P<0.05）以及住院前口服抗菌治疗无效。
